| NPI | 1134467590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIEN J THOMAS Owner/Clinical Director 601-981-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 1425) |
| Enumeration Date | 2013-01-19 |
| Last Update Date | 2020-06-15 |